In the very early days of breastfeeding, you may need some help getting settled, but once you get the hang of tandem feeding you’ll be able to manage it all by yourself!!  Here are some tips:

1. Create a nursing “nest” someplace with extra room – maybe on the bed or the couch, or even the floor (rather than a rocking chair or armchair).  This will give you some space to spread out as you get everyone settled. Arrange your pillows in advance and have a basket with the phone, TV remote, water, and maybe a special toy or book for your 2-year-old to make nursing time special.  Some mommies make a nest in the corner of an L-shaped sofa, and another may use one of those arm/back pillows for support in bed.
2. Put the babies in a safe “holding area” that you can reach from your “nest.”  Some moms use a crescent shaped nursing pillow (something like a Boppy pillow or “baby lounger”) on either side of them on the couch, or a bouncy seat on either side on the floor.  When they’re smaller, you may be able to just rest them on the couch next to you, depending on your furniture setup.
3. Get settled with the pillow, then lift one baby at a time up onto the pillow with you.  You may want to use a rolled up receiving blanket behind the baby for added support and reassurance, though the baby is more likely to roll toward you than away as you lean over for the second baby.  Sometimes having the babies swaddled makes them easier to scoop up – you can unswaddle them once they’re on the pillow.
4. Once both babies are on the pillow, many moms latch the “easier” baby first, then help the baby that needs some extra assistance. Others start with the baby with the stronger suck, so that baby’s sucking will help out the second baby.
5. To burp the babies, you can keep one baby latched while lifting the other to an upright burping position, or roll the “need-to-burp” baby onto his/her tummy to burp.

  You can also nurse laying down. Some moms find that at night they prefer to feed one baby at a time, while others create a semi-reclined nursing position and cradle one baby in each arm.  Depending on how big your babies are, you may need to adjust to find a comfortable position that still enables the babies to have a nice, deep, comfortable latch.

Will I have enough milk to breastfeed twins?

  Many new moms worry about whether they will have enough milk but, in fact, there are very few women who don’t have enough. Milk supply works on the principle of supply and demand. Breastfeeding tells a mother’s body to produce more milk in response to her baby’s (or babies’) needs. With two babies, more milk is removed from the breasts so more milk is made. The best way to make sure you establish a good supply is to feed your babies often in the early weeks and to ask someone knowledgeable to help you check that they are latched on and breastfeeding correctly.

  During the first few months, babies go through growth spurts. Some mothers interpret this more frequent feeding as a sign of a lack of milk, but if they allow babies to feed more often for a day or two, their breast milk supply will swiftly increase and feeding will settle into a pattern again. Moms expecting twins aren’t always encouraged to consider breastfeeding, but twins, and even triplets, can be breastfed exclusively.

How can I breastfeed two babies?

  Confidence and the belief that it can be done are two of the most important factors in making breastfeeding twins a success. Attending a breastfeeding support group or workshop while you are pregnant is a good way to increase your confidence and find out where to get support locally. If you have any questions after your babies are born, you’ll then know whom to ask. Perhaps your healthcare provider, midwife, doula or breastfeeding counsellor can put you in touch with someone who has breastfed twins!

  Twins can be breastfedfed separately or together. Many mommies find that they do both in different situations and when their twins are at different stages of development. Feeding babies together can be a good way to establish a plentiful milk supply quickly and can save time. The football hold can be useful for one or both babies as well as (or instead of) the more traditional cradle position. While mom and each baby are still learning about breastfeeding, it may be easier to spend some time feeding the babies separately.

Some of the possible positions for feeding twins together

   V-shaped cushions are useful when feeding two young babies at once but ordinary pillows or cushions can also be used to help support the babies. If you have someone to help you in the early days, they can help you position a second baby after the first one has started feeding. As the babies grow and their head control develops, it´ll be easier to breastfeed them together without pillow support or an extra pair of hands. Later still, the babies will be able to position themselves.

   Many mommies find that, in the first few weeks, it works well for each twin to have his own breast, to establish his own milk supply. There may be exceptions to this depending on the relative size and growth of the babies. Later, some mothers prefer to vary the positions of each baby and don’t always offer the same breast to the same twin.

  As with everything in parenting, you will become the expert in your babies.  This is one method, but certainly not the only one.  Do what works for you!!

Problematizing Choice in the Elective Cesarean Debate

  A consideration of Henci Goer’s research around the issue of elective cesarean surgery in the United States reinforces the contention that the popular representation of elective cesarean surgery as a choice over which women are demanding more control is in fact both misguided and misinformed. Goer suggests that the research that is cited to buttress the claim that women prefer cesarean surgery over vaginal birth “supports nothing of the kind,” cites ten different studies that have been conducted to ascertain women’s preferred mode of birth and concludes that rather than electing or requesting cesarean surgery, the vast majority of women “merely agreed with the decision…or wanted [a cesarean section] in belief that it would be safer for themselves or their infants” (Goer 2001, 34).

   What comes out is the recognition that the representation of elective cesarean surgery as a safe and equal alternative to vaginal birth that women are demanding the right to choose is supported by existing ideologies and power systems rather than based on any clear picture of scientific evidence!!! However, because perceived science is the dominant and authoritative voice that surrounds birth within a Western medical model of care, this representation is accepted as true and serves to further a picture of cesarean birth as normal and safe, despite the fact that, upon investigation, these claims appear to “contravene everything known about the comparative risks” (Goer 2001, 34).

  The result of placing the debate about elective cesarean surgery within the context of a rights-based discourse is that cultural ideologies about equality and autonomy are employed without any consideration for the broader economic, social and bureaucratic factors that surround and contribute to the lived experiences of women. And while we must admit, it is possible to imagine a situation in which a woman, in conjunction with her doctor’s advice and information, pursues and receives cesarean surgery, may be and many times are happy with her decision and pleased with the outcome of a live and healthy baby. However, the contention here is that, while this scenario is imaginable, it is a far cry from the “groundswell of consumer demand” (Goer 2001, 35) that the Western media representation of the debate would have us believe exists. The hegemony of a biomedical perspective relies, in part, on the public perception of its knowledge as right, true and the best information on which to make decisions and take actions.

Resource:

Goer, Henci. (2001) The Case Against Elective Cesarean Sections. Journal of Perinatal & Neonatal Nursing 15(3): 23–38.

The Logic in Rising Induction Rates

     I’m a seasoned doula with an innate faith in childbirth as a normal, natural function. When I hear that one-third of American women are given chemicals to start labor, I have to either conclude that women have somehow lost the ability to give birth or that we are witnessing a societal change. If women are being induced for the legitimate reasons of health and safety, then mortality and morbidity statistics should be improving. Yet the statistics are quite flat. We see little change in US statistics, except for in the category of tiny, preterm babies. An induction and augmentation rate of over 35% has not seemed to improve the health of mothers or babies. It has, however, strongly impacted the cesarean rate and—subsequently—the rate of VBAC and uterine rupture after prior cesarean section.

    Induction is so common that many people are unaware of the risks. Even a “simple,” uncomplicated induction can begin an avalanche of interventions. It often starts with a cervical stretch and sweep to “ripen” the cervix, IV Pitocin, electronic fetal monitoring (EFM) and amniotomy; then, perhaps, it’s on to an intrauterine pressure catheter, amnioinfusion for unusual fetal heart tones, an epidural for the pain of Pitocin-induced contractions and malrotation or poor descent because of the epidural; then maybe a vacuum extraction or cesarean is performed for “failure to progress.” It goes on and on. The mother ends up with lifelong injury to her uterus. Her baby may be stressed and separated from the family. A normal birth may turn into a nightmare. And that’s if all goes well! If there are complications or a surgical emergency then the nightmare really begins.

   Induction is a minefield, a setup for complications. An induced labor forces the baby out before the body is ready, before the complex hormone interaction has primed the cervix and often before the baby has reached his full intrauterine maturity. We have drugs now that can produce contractions and soften the cervix but this is only a small part of the complicated process of labor. We can make a woman have contractions but we don’t always succeed in forcing her body to release the baby and give birth. If we start a labor with chemicals, we may very well have to finish the labor with the surgeon’s scalpel.

   In some studies, induction raises the risk of cesarean by 800%. EFM must be used in all chemical induction methods because of the risk of hypertonic contractions and fetal distress. Electronic fetal monitoring alone increases the risk of cesarean and of vacuum extraction or forceps. Amniotomy increases the risk again. Cesarean for fetal distress is even more common—whether the distress is real or a result of EFM artifact—since non-reassuring fetal heart tones are frequently observed. Meconium staining, meconium aspiration syndrome and even shoulder dystocia are directly associated with inductions. The rise in induction closely mirrors the rise in cesarean delivery, as does the rising incidence of post-cesarean rupture. A woman with a prior cesarean is unlikely to suffer a uterine rupture (odds are usually given under 1 %). But if she is induced, her risk may rise to 2–4 %.

    If the data shows that induction is a risky procedure, and we see little statistical benefit, then why are we inducing so often? Doctors and midwives will express many reasons for induction, but many of those reasons are colored by a misunderstanding of the risks involved. The risks created by induction are sometimes ignored—induction seems simple and easy. Any complications or problems are seen as simple chance—the “normal risk” of birth—caused by the situation that prompts the induction.

— Gail Hart
Excerpted from “Induction and Circular Logic” in Midwifery Today’s The Postdates and Postmaturity Handbook

Birth Art by Amy Swagman

Were you hoping to have a vaginal birth, only to find out you were expecting twins? You’re not alone, but expecting twins does not usually rule out vaginal birth. The greatest things you can do to ensure a positive outcome with your twin birth are actually best done during the pregnancy! After all, if you can avoid setting yourself up for pregnancy complications that can make birth difficult or encourage preterm labor, you’ve won half the battle! Of course, not all complications ruling out natural birth can be prevented. However, you greatly increase your chances of a natural, healthy birth if you and your babies are well-nourished, well-hydrated, and well-rested.

The following are some great ways to avoid bed rest and keep yourself strong:

•    Diet:  Whether you’re carrying twins, triplets, or more, you should plan to eat at least five times a day (three meals and two substantial snacks), even if you don’t feel especially hungry.Of course, not all calories are created equal. Make them count by going easy on sugar and eating a variety of foods packed with the nutrients you need, including protein, carbohydrates, and, yes, fat. Pregnancy is no time for a lean diet.Cheese, milk, meat, eggs, nuts, and oils will all help fuel your babies’ growth. Fill out your diet with lots of fruits and vegetables, and at least ten servings of grains.  Some experts recommend drinking up to a gallon of water — that’s 16 8-ounce glasses — each day. You can get some of your fluids from milk and juice, but water should be your go-to beverage.

• Exercise:  If you’re a healthy, active woman with twins on the way, you can probably continue to exercise during your pregnancy, as long as your practitioner gives the go-ahead.Keep it slow, relaxed, and gentle. Your body — and your babies — may not be able to handle intense workouts. Good options include swimming, walking, water aerobics, and prenatal yoga.Be sure to get plenty of fluids before, during, and after your workout. And no matter what exercise you enjoy, stop immediately if you develop pain, dizziness, or heart palpitations.

• Prenatal vitamins:  Prenatal vitamins are important, but you don’t need a special “twins and triplets” formula. A standard prenatal supplement will do just fine. However, an added supplement is the best way to ensure that you get vital nutrients such as extra folic acid folic acid, iron, and calcium. Your practitioner can recommend specific brands and doses.Women carrying more than one baby are at a higher risk for iron-deficiency anemia during pregnancy. Your practitioner will monitor the level of iron in your blood to make sure you’re getting enough. Research different high iron veggies.

• Care Provider:  Other than taking good care of yourself during your twin pregnancy, the next thing you can do to make a positive birth experience more likely is choose a provider and birth doula who suits your needs and desires. If it is important to you to have a vaginal birth, you’ll want to choose a provider who has plenty of experience with vaginal twin birth. Ask your provider how many vaginal twin births s/he has attended, and also what his or her cesarean rate for twin pregnancies is. Not all twins can or should be born vaginally, but if you don’t have a provider with experience attending vaginal twin births, your chances of having a vaginal birth, even if it is a possibility in your case, decrease dramatically.

  CBS NEWS reports that a toddler dies following routine circumcision at  a NYC Hospital.  This is beginning an investigation on a pretty large scale in search of how many un- reported  deaths are caused by these elective surgeries. 

This devastated Brooklyn family’s loss is now added to the appx 118 families that suffer this same loss.

Jamaal Coleson Jr., who would have turned 2 next month, died on Tuesday, hours after undergoing the medical procedure at Beth Israel Medical Center.

The Coleson family told CBS  the young child was given a general anesthetic instead of a local.

The New York State Department of Health is now investigating the case.

If more educators would empower each family about the true risks that come with this elective risky surgery, we would have 118 less un-necessary deaths per year.

Here are some quick facts about circumcision:

Quick Facts:

• Babies feel as much, or more, pain than adults
• Circumcision hinders a baby boy’s ability to trust and to feel loved
• Sixty-six percent of all newborn American boys are NOT circumcised
• Canada has ceased infant circumcision coverage in its national health plan
• About 7/8ths of the world’s men are not circumcised
• No medical association recommends infant circumcision, and some caution against it, including the American Academy of Pediatrics
• Circumcision interferes with breastfeeding and adversely affects the mother/child bond
• Every year, about 100 boys die as a consequence of being circumcised, through infection, shock, or blood loss
• Private insurance companies are dropping coverage for circumcision. Medicaid no longer covers circumcision in Arizona, California, Colorado, Florida, Idaho, Louisiana, Maine, Minnesota, Mississippi, Missouri, Montana, Nevada, North Carolina, North Dakota, Oregon, South Carolina, Utah, and Washington
• Circumcision trauma is associated with permanent changes to the brain
• Male and female sexual sensation is reduced by circumcision
• Circumcised men are more likely to experience erectile dysfunction

*cited from icgi.org 7/30/11

My hope is that you will find here the information you need to better understand the impact of abuse or trauma on pregnancy, labor & childbirth and mothering; a sense that you are not alone and that there are caring people willing to listen. It is important to realize that birth can cause serious triggers & this is a fact that cannnot be ignored. Many people care about your safe passage into motherhood & my goal is that you find the necessary resources to heal.

For many survivors, oing research online is not safe. Please check out http://www.wrcnrv.org/helpingYou/cs_howToHide.shtml to learn about internet safety.

It takes much courage and willingness to search out information that may be of use to you in your journey towards motherhood. We invite you to read the following information at your own pace. It may be overwhelming to read all in one visit. You are not alone, you are strong, and there are people who care about your well-being and the well-being of your baby.

There are many shapes of nipples; thimble shaped, rounded, pointy, flattened, dimpled, and truly inverted.  Most types of flattened and inverted nipples will not cause a problem during breastfeeding and if they do, there are ways to overcome them and succeed at breastfeeding. Babies feed from the breast not from the nipples – hence the term BREAST-feeding and not nipple-feeding. A breastfeeding baby draws the nipple far back into his mouth in order to suck effectively. Sometimes flat or inverted nipples can cause baby to have difficulty drawing the nipple deep into his mouth.

  Most babies at birth will begin to tug the nipple with their tiny fingers. In doing this they are elongating & stimulating the nipple, sort of preparing it for the first nurse session. They are usually very successful at getting enough nipple into the “soft pallet” of the throat.  Keeping your baby with you & allowing him to learn how to latch is done easiest before your mature milk come in.  When this still is not enough, other options need to be explored.

Listed here are a few:

1. Basic correct latch-on technique is very important. Making sure the baby opens very wide and takes in a large amount of the areola will provide a more comfortable latch.  These techniques can be learned at my breasefeeding class.
2. Massage Therapy to gently break-up binding tissues is an effective treatment for inverted nipples. This includes localized massage and manipulation of the constricted tissues at the base or areola area. Here’s what you can do. First, gently squeeze your areola until the inverted nipple ‘pops up’. Gently grasp your nipple, then with your other fingers target the areola area where you’ll gently but firmly pull down and then outwards in an action designed to place pressure on the underlying constricted tissues binding your areola. Your thumbs can balance the technique so that pressure is applied in a balanced manner.
3. Use an electric breast pump, or the Evert-It Nipple Enhancer just before feeding your baby. 
4. Wear  breast shells designed for flat or inverted nipples between feedings or for thirty minutes before feedings. Breast shells are made of plastic. They have two parts: a back with a hole through which the nipple can protrude and a rounded dome that fits inside your bra. Pressure on the shell from your bra against the areola gradually stretches out adhesions and allows the nipple to protrude. Be sure to wash these shells with soap and hot water between feedings and discard any milk that collects in them while you wear them in your bra. Note that shells come with two types of backs; the one with the larger hole is meant for treatment of sore nipples. Be sure to use the back with the small hole, which fits close to the nipple base.
5. Lastly, if your baby is still struggling to latch on, try a nipple shield. You can get these from a lactation consultant or breastfeeding counselor who will also guide you on how to use the nipple shield without compromising your milk production.

  Breastfeeding Classes are back due to popular demand! This is a great class to combine with a 4 week child birth class or for a mom who just needs a refresher.  Most families want to do the best for their baby so it’s no surprise the breastfeeding trend is on the rise.  While many mothers intend to breastfeed, they don’t prepare for potential challenges.  Without the tools education provides & a strong support system, she is likely to give in to formula  during a rough night.  In my complete & comprehensive breastfeeding class we will learn:

• how often to feed your baby
• successful components of a healthy latch
• different breastfeeding positions
• pumping for working moms
• normal challenges
• when and who to call for help (creating your support system)
• …and so much more!

 BF class: $50.00   $10.00 discount for childbirth class students

 Small classes are taught in a small, cozy setting at Lover’s Lane Birth Center.  I teach through lecture, hands on role play, and videos so all learning styles may be accommodated. This is a 3 hour class so please bring a snack & dress comfy. Please call to set up your class today!

Avery Karnes~  Unfortunately, I had a lot of trouble
getting breast-feeding going.  All I wanted was for my baby boy to
experience this amazing bond with me and be nourished. But when my
milk came in on the 3rd day post-partum, I was engorged and in serious
pain, so bad that no matter what I tried I couldn’t get a drop out and
I couldn’t stand to nurse at all. I felt so defeated and inadequate
for my child. Rosemary swooped in and saved Sebastian’s chances of
being a breast-fed baby. She personally came over and showed Tyler and
I what to do to stop the engorgement and release the milk. She worked
with us for 2.5 hours in our home and by the end of the night
Sebastian had nursed for 1.5 hours and received much needed milk! I
don’t know what we would have done without her. I truly feel that God
sent us Rosemary. If she hadn’t helped us with such altruism we would
have probably given up. Thanks to her Sebastian was breast-fed and
well bonded with his Mommy. Even now at 9mths old I can see that
there’s really something so special between mother and son that may
have never occurred without Rosemary’s intervention. I can’t say thank
you enough!

Contact:

Rosemary Walker-Beyer CD (DONA), CBE, BE

sweetbirth101@yahoo.com

972.231.4616

The Myth About Dads & Doulas

 As a Birth Doula I believe that we are a very important role player in most births.  Many fathers feel threatened by the idea of someone else being the support person to their partner during this glorious event.  It is very important that we respect and enhance the role of the father. We do a great job of this as well as simutaneously providing support to him. Here’s what some Sweetbirth Dad’s are saying! 

My Experience With A Doula (from a man’s perspective)

  Like most fathers I was skeptical at first, I mean I’m the dad.  The last thing I need is another woman in the delivery room, right?

  Man was I ever wrong.  Having Rosemary there took a major strain off of me and my fiance/wife.  She knew exactly what to do and when to do it.  Not only that, she was also a strong ally in the hospital room.

  Rosemary has a wealth of knowledge and skill.  It just seems to come natural to her.  My fiancee and I wanted a natural, beautiful, and memorable birth for us and our son to be.  Her OB/GYN and the hospital staff, however, had a different agenda.

  Despite the hospitals efforts to discourage us, Rosemary encouraged us to have the birth we wanted.  It was all that we had hoped it would be, but her care and kindness did not stop at the delivery room.  She was there to help during the difficult first days of having a new born, and is still there for us today.

  My wife Desirea and I would like to extend our thanks to Rosemary, and we highly recommend her to any one expecting a child.

-Josh, Desirea, & Adam Levrette

Garland, TX

September 2010

  When my wife first suggested we look into a doula (and after I learned what a doula does),  I thought, “Why do we need someone else in the delivery room?  I should be all that my wife needs!”  Then after meeting Rosemary Walker, I began to realize there was more to a doula  than I originally thought and decided to have an open mind.

  Turns out, Rosemary was an invaluable resource in and out of the delivery room.  She was  patient and dependable while we were preparing our birth plan, and she was available and informative anytime we called her with questions, especially the night we checked into the hospital.  But the real benefit was realized in the delivery room.  She came prepared to assist my wife with the birth as well as brought snacks to keep me going during the 10-hour labor. 

  My wife was determined to have an all natural childbirth, and the techniques Rosemary utilized (in which I was able to assist with) I believe helped ease the struggle my wife was going through.  I would never have been able to do it all by myself. 

  Rosemary was also a strong advocate for our birth plan and worked in tandem with our physician and hospital staff to allow us to experience the birth we planned and hoped for.  She was a tremendous asset when we had our first baby, and I would not hesitate to use her again to assist us with any future childbirths.  She was a true professional but also became a good friend, even to this day.                                    

-Paul, Melissa, & Jason Baumler

Plano, TX

February 2008